Evaluation of clinical efficacy of immediate implant placement into debrided infected sockets using demineralized freeze-dried bone allograft and platelet rich fibrin membrane: a clinical trial

Authors

  • Deepali Sharma BDS, MDS Oral and Maxillofacial Surgery, Sandalwood Smiles Dentistry, Brampton, Ontario, Canada
  • Ankita Gupta Department of Public Health Dentistry, Indira Gandhi Government Dental College, Jammu, J&K-UT, India http://orcid.org/0000-0002-3948-3682
  • Puja Jha Department of Periodontology and Implantology, Tooth Healers Dental Clinic, Kathmandu, Nepal
  • Swapnil Sachan Department of Oral and Maxillofacial Surgery, SP Dental and Maxillofacial Trauma Centre, Jammu, J&K-UT, India
  • Varun Kumar Department of Oral and Maxillofacial Surgery, SP Dental and Maxillofacial Trauma Centre, Jammu, J&K-UT, India
  • Kamaljeet Manhas Department of Periodontology, Divya Jyoti Dental College, Modinagar, Uttar Pradesh, India.
  • Pulkit Vaid Department of Pediatrics and Preventive Dentistry, Desh Bhagat Dental College, Punjab, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20220059

Keywords:

Immediate implant, Periapical pathology, Bone allograft, PRF membrane

Abstract

Background: The aim of the study was to evaluate the clinical efficacy of demineralised freeze dried bone allograft (DFDBA) and platelet rich fibrin (PRF) membrane in immediate implant placement into debrided infected mandibular molar sockets.

Methods: A clinical trial was conducted on 15 adult patients requiring tooth extraction and replacement with endosseous implants. Atraumatic tooth extraction was followed by thorough debridement of the socket prior to implant placement. Demineralized freeze dried bone allograft and PRF membranes were used for guided bone regeneration. Pain, signs of infection, vertical bone height measurements (IS-BIC) and stability of implants (torque values) were assessed using paired t test, analysis of variance (ANOVA) and Chi-square test.

Results: Statistically significant reduction in pain from immediate post-operative (post-op) day to 1st post-op day, 7th post-op day to 4 months post-op (p=0.006) was seen. Infection was present preoperatively and absent post-op 1st day, 7th day and 4 month in all the subjects. The mean IS-BIC was 2.30±2.27 mm post-op and 0.75±0.74 mm at 4 months. Average height gain on mesial and distal side was 1.55 mm (p=0.009).

Conclusions: With proper pre-op and post-op care, immediate implant placement along with DFDBA and PRF membrane in teeth exhibiting periapical pathology, is a cost effective, time saving and reliable treatment option.

Author Biography

Ankita Gupta, Department of Public Health Dentistry, Indira Gandhi Government Dental College, Jammu, J&K-UT, India

Department of Public Health Dentistry

References

Adell R, Lekholm U, Rockler B, Bränemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981;10:387-416.

Barzilay I. Immediate implants: their current status. Int J Prosthodont. 1993;6:169-75.

Lazzara RJ. Immediate implant placement into extraction sites: surgical and restorative advantages. Int J Perio Rest Dent. 1989;9:332-43.

Del Fabbro M, Boggian C, Taschieri S. Immediate implant placement into fresh extraction sites with chronic periapical pathologic features combined with plasma rich in growth factors: Preliminary results of single-cohort study. J Oral Maxillofac Surg. 2009;67:2476-84.

American Academy of Periodontology. Glossary of Periodontol Terms, 4th edition. Chicago: American Academy of Periodontology. 2001;44.

Nevins M, Mellonig JT, Clem DS. Implants in regenerated bone: Long-term survival. Int J Periodontics Restorative Dent. 1998;18:34-45.

Seibert JS. Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part I. Technique and wound healing. Compend Contin Educ Dent. 1983;4:437-53.

Schwartz Z, Mellonig JT, Carnes DL, Fontaine JDL, Cochran DD, Boyanm BD. Ability of Commercial Demineralized Freeze-Dried Bone Allograft to Induce New Bone Formation. J Periodontol. 1996;67:918-26.

Choukroun J, Diss A, Simonpieri A, Girard, Schoeffler C, Dohan SL. Platelet-rich fibrin (PRF): A second-generation platelet concentrate.Part IV: Clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:56-60.

Anitua E, Piñas L, Alkhraisat MH. Long-Term Outcomes of Immediate Implant Placement Into Infected Sockets in Association With Immediate Loading: A Retrospective Cohort Study. J Periodontol. 2016;87(10):1135-40.

Hsu YT, Chou YS, Yang TH, Wu YM, Huang CL, Ho KY. Simultaneous Implantation and Guided Bone Regeneration Using a Platelet-Rich Fibrin Membrane: Two Case Reports. Clin Advances Periodont. 2017;7(1):19-24.

Baslarli O, Tumer C, Omer U, Betul V. Evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin. Med Oral Patol Oral Cir Bucal. 2015;20(1):111-6.

Marconcini S, Barone A, Gelpi F, Briguglio F, Covani U Immediate Implant Placement in Infected Sites: A Case Series. J Periodontol. 2013;84(2):196-202.

Meltzer AM. Immediate implant placement and restoration in infected sites. Int J Periodontics Restorative Dent. 2012;32(5):169-73.

Fugazzotto P. A retrospective analysis of immediately placed implants in 418 sites exhibiting periapical pathology: results and clinical considerations. Int J Oral Maxillofac Implants. 2012;27(1):194-202.

Bell CL, Diehl D, Bell BM, Bell RE. The immediate placement of dental implants into extraction sites with periapical lesions: a retrospective chart review. J Oral Maxillofac Surg. 2011;69(6):1623-7.

Truninger TC, Philipp AO, Siegenthaler DW, Roos M, Hämmerle CH, Jung RE. A prospective, controlled clinical trial evaluating the clinical and radiological outcome after 3 years of immediately placed implants in sockets exhibiting periapical pathology. Clin Oral Implants Res. 2010;22(1):20-7.

Koutouzis T, Lundgren T. Crestal bone-level changes around implants placed in post-extraction sockets augmented with demineralized freeze-dried bone allograft: a retrospective radiographic study. J Periodontol. 2010;81(10).

Mazor Z, Horowitz RA, Corso MD, Prasad HS, Rohrer MD, Ehrenfest DMD. Sinus Floor Augmentation With Simultaneous Implant Placement Using Choukroun’s Platelet-Rich Fibrin as the Sole Grafting Material: A Radiologic and Histologic Study at 6 Month. J Periodontol. 2009;80:2056-64.

Crespi R, Cappare P, Gherlone E. Fresh-socket implants in periapical infected sites in humans. J Periodontol. 2010;81:378-83.

Casap N, Zeltser C, Wexler A, Tarazi E, Zeltser R. Immediate placement of dental implants into debrided infected dentoalveolar sockets. J Oral Maxillofac Surg. 2007;65:384-92.

Siegenthaler DW, Jung RE, Holderegger C. Replacement of teeth exhibiting periapical pathology by immediate implants: A prospective, controlled clinical trial. Clin Oral Implants Res. 2007;18:727-37.

Quirynen M, Gijbels F, Jacobs R. An infected jawbone site compromising successful osseointegration. Periodontol. 2000;33:129-44.

Meredith N. Assessment of implant stability as a prognostic determinant Int J Prosthodont. 1998;11(5):491-501.

Novaes AB, Novaes AB. Immediate implants placed into infected sites: A clinical report. Int J Oral Maxillofac Implants. 1995;10:609-13.

Albrektsson T, Zarb GA. Current interpretations of the osseointegrated response: clinical significance. Int J Prosthodont. 1993;6(2):95-105.

Kersten P, Küçükdeveci AA, Tennant A. The use of the Visual Analogue Scale (VAS) in rehabilitation outcomes. J Rehabil Med. 2012;44(7):609-10.

Baron M., Haas R., DMD, Dörtbudak O, Watzek G. Experimentally Induced Peri-implantitis: A Review of Different Treatment Methods Described in the Literature. Int J Oral Maxillofac Implants. 2000;15:533-44.

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Published

2022-01-25

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Original Research Articles